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插入式腹部按压心肺复苏术与标准心肺复苏术对心脏骤停后呼气末二氧化碳及自主循环恢复影响的比较:一项临床试验

A Comparison of the Effect of Interposed Abdominal Compression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation Methods on End-tidal CO2 and the Return of Spontaneous Circulation Following Cardiac Arrest: A Clinical Trial.

作者信息

Movahedi Ali, Mirhafez Seyed Reza, Behnam-Voshani Hamidreza, Reihani Hamidreza, Kavosi Ali, Ferns Gordon A, Malekzadeh Javad

机构信息

Department of Anesthesia and Operating Room Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran.

Department of Intensive Care Nursing, School of Nursing & Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Acad Emerg Med. 2016 Apr;23(4):448-54. doi: 10.1111/acem.12903. Epub 2016 Mar 20.

Abstract

OBJECTIVES

Sudden cardiac arrest is a major cause of death in the adult population of developed countries, with only 10%-15% of cardiopulmonary resuscitations (CPRs) being successful. We aimed to compare the effects of interposed abdominal compression CPR (IAC-CPR) with standard CPR (STD-CPR) methods on end-tidal CO2 (ETCO2 ) and the return of spontaneous circulation (ROSC) following cardiac arrest in a hospital setting.

METHODS

After cardiac arrest was confirmed in a patient at Mashhad Ghaem Hospital, 80 cases were randomly assigned to one of the two methods of resuscitation, either IAC-CPR or STD-CPR, respectively. The inclusion criteria for the study were nontraumatic cardiac arrest, in patients between the age of 18 and 85 years, and the presence of endotracheal tube. Exclusion criteria were abdominal surgery in the past 2 weeks, active gastrointestinal bleeding, pulmonary embolism, and suspected pregnancy.

RESULTS

There was a significant difference between the two groups in ETCO2 (p < 0.003), but there was no significant difference as far as the ROSC (p > 0.50).

CONCLUSION

The increase in the ETCO2 during IAC-CPR is an indicator of the increase in cardiac output following the use of this method of CPR.

摘要

目的

心脏骤停是发达国家成年人群死亡的主要原因,心肺复苏(CPR)成功率仅为10%-15%。我们旨在比较医院环境下心搏骤停后,插入式腹部按压心肺复苏(IAC-CPR)与标准心肺复苏(STD-CPR)方法对呼气末二氧化碳分压(ETCO2)和自主循环恢复(ROSC)的影响。

方法

在马什哈德加姆医院确认患者心脏骤停后,80例患者被随机分配至两种复苏方法之一,即分别采用IAC-CPR或STD-CPR。该研究的纳入标准为年龄在18至85岁之间的非创伤性心脏骤停患者且已插入气管插管。排除标准为过去2周内有腹部手术史、活动性胃肠道出血、肺栓塞及疑似妊娠。

结果

两组间ETCO2有显著差异(p < 0.003),但ROSC方面无显著差异(p > 0.50)。

结论

IAC-CPR期间ETCO2升高是采用该心肺复苏方法后心输出量增加的一个指标。

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